Risk of Surgical Complications Up for Overlapping Hip Surgery

Last Updated: December 04, 2017.
For patients undergoing surgery for hip fracture or total hip arthroplasty, overlapping surgery is associated with increased risk of surgical complications, according to a study published online Dec. 4 in JAMA Internal Medicine.

Bheeshma Ravi, M.D., Ph.D., from the University of Toronto, and colleagues examined whether overlapping surgery is associated with greater risk of complications in a retrospective population-based cohort study for 2009 to 2014. Participants from two large cohorts were included and followed up for one year. The hip fracture cohort included all persons aged older than 60 years who underwent surgery for a hip fracture, while the THA cohort included all primary elective THA recipients for arthritis. Overlapping and nonoverlapping hip fractures were matched for patient age and sex, surgical procedure (for the hip fracture cohort), primary surgeon, and hospital.

The researchers identified 38,008 hip fracture surgeries, of which 2.5 percent were overlapping. There were 52,869 THAs, 3.0 percent of which were overlapping. Overlapping hip fracture procedures had an increased risk of complications after matching, as did overlapping THA procedures (hazard ratios, 1.85 and 1.79, respectively). Increasing duration of operative overlap correlated with increasing risk for complications among overlapping hip fracture operations (adjusted odds ratio, 1.07 per 10-minute increase in overlap).

"These findings support the notion that overlapping provision of surgery should be part of the informed consent process," the authors write.